At work you may have difficulty meeting professional obligations, indicated by:

Trouble concentrating or remembering things

Procrastination

Feelings of being overwhelmed

Lowered productivity

Missed Deadlines

Case stagnation and neglect

Dreading answering the phone or opening mail

Making excuses to partners

Making excuses to clients

Feelings of being incapable of managing your caseload

Or, you may try to throw yourself into work in order to ignore your symptoms. No one is completely immune from depression. It is a leading cause of disability in the United States, affecting 10% of the population. Women are twice as likely to be diagnosed and treated for major depression as men. Depression may be masked by alcohol or drug abuse. More than 80% of people with depressive illness improve with appropriate treatment.

Depression: A Lawyer's Story

Depression is a serious, potentially life-threatening mental disorder. While I am sure there must be people who are able to recognize, diagnose, and manage their own depressions, I don't know of any. Life brings with it all sorts of challenges, and things like divorce, death and financial disaster can lead even the healthiest person through some pretty dark days. But when those dark days turn into weeks, when the thought of getting out of bed, taking a shower and choosing an outfit seems impossible, and especially when life, for good reason, bad reason, or no reason at all, ceases to have any meaning, it's time to ask for help. If family and friends are unable or unwilling to get involved, there are numerous professionals and organizations equipped to deal with just such a crisis. If it's a question of personal safety, the local emergency room is as good a solution as any. The Maine Assistance Program for Lawyers and Judges is a unique resource to assist the impaired lawyer or judge.

I wrote my first suicide note (mailed to my parents) from boarding school in the 10th grade; I told them that by the time they had opened the letter, I would have thrown myself from the top floor (4 stories) of the Library. Everyone felt that this was due to homesickness and the intense academic pressure of an elite prep school - a "normal" reaction, under the circumstances. Hah. I slept every minute I wasn't studying or in class, and my roommates became accustomed to finding me hunched on the floor of my closet. But my grades never dropped and I never confided in anyone that I spent most of my days dragging myself from one obligation to the next, always pretending to feel better than I did, and in constant terror of failing at anything and everything. Indeed, for years I attributed my depression to the stress of having to overachieve at a school full of overachievers.

But the depressive episodes followed me into college and law school, into my early years of practice and motherhood. As I approached each new phase of life, I hoped and expected that the change in circumstances would occasion a change in mood - and often, it did, for a time. Mental illness was not a topic of discussion during my childhood or school years. Besides, how could someone who appeared to be so successful academically be really, truly sick in the head?
The first indication that something was very wrong came in the wake of my first marriage - a disastrous experiment lasting three months. Among other things, I lost twenty pounds, and when my family finally intervened, I was retrieved from my third year of law school in Washington, D.C. and brought home to recover. Shortly after, I had a breakdown of sorts, threw a picture frame at a window, and was finally sent to a psychiatrist. I was told I was in a clinical depression, understandable under the circumstances, and prescribed Prozac. (This was in 1988, so Prozac was still the wonder drug). It worked for a time. I pulled myself together and managed to graduate from law school with my class. I did it, I think, out of that same old fear of failure. In any event, the depression was deemed by all to be a thing of the past.

In short order, I remarried, joined a large firm in Boston, and had my first child. Life seemed to be evening out. In 1994, however, my son was born with a life-threatening birth defect and I had no reserves for coping with it. After major surgery, he gradually got better, but I had already been severely traumatized by the experience. Over my son's first year of life, I lost ground quickly, becoming unable to care for his medical needs, unable to practice law, run my household, even get out of bed on many mornings. Shortly after his first birthday, the family decided I needed serious help - of the psychiatric ward sort.

Since that initial hospitalization, I have been in and out of various psychiatric hospitals in New England a number of times - the last time over a year ago. For many years, I fought the diagnosis of mental illness. I took prescribed psychotropic medications when and if I felt like it. Three of my hospital stays followed serious suicide attempts, and when those occurred, nothing in the world could persuade me that life was worth living - not my kids, my home, my career - nothing. For me, the suicide attempts were not a cry for help; I was checking out, and it is a matter of coincidence, vigilance on the part of family and friends, and the grace of God that I am alive today. I have been on every psychiatric drug under the sun, have had numerous ECT treatments and have at times practically lived at McLean Hospital in Belmont, Massachusetts.
There are no magic cures for this disease - and it is a disease. I have read just about everything I can get my hands on about it, and I still find it baffling, as do so many of the experts. There is a large genetic component - which is to say that depression runs in families. There is a large physical component - chemical imbalances in the brain can actually be tracked on PET scans (electronic images of brain activity). And there is a large psychological component - which is to say that how and what you think can affect your brain chemistry and your overall health.

I have inherited a genetic condition that I neither asked for, nor deserved. Treatment for this condition includes medical treatment, with which it is my sole responsibility to be aggressive and compliant. It also includes the talk therapy that helps me combat thinking in frightened, negative, depressive cycles. All of these require a level of vigilance above anything I ever thought possible. The reward of such vigilance is the ability to live through both the ordinary and extraordinary events of life, a reward well worth the effort, as my children, family, friends and colleagues will only be too happy to confirm.